Family and Community Dynamics of Substance Abuse Among Youths in Bushenyi District, Western Uganda

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Understanding the influence of family and community dynamics is critical for designing effective prevention strategies. Aim This study investigated the relationship between family and community factors and substance abuse among youths in Bushenyi District, Western Uganda. Methods A cross-sectional study design was employed. Structured questionnaires were administered to 381 youths aged 18–30 years, collecting sociodemographic information and data on family and community influences (parental drug use, home rules, peer influence, and law enforcement). Descriptive statistics summarised the data, chi-square tests assessed associations, and logistic regression identified predictors at a 5% significance level. Results Early initiation of drug use was common, particularly in bars and among peer groups. Substance abuse was significantly associated with parental drug use (χ2 = 102.68, p < 0.001), living arrangements (χ2 = 21.46, p = 0.001), peer influence (χ2 = 13.40, p = 0.001), and weak law enforcement (χ2 = 12.95, p = 0.001). Regression analysis showed that strict home rules were protective (Exp(B) = 0.325, p < 0.001), while weak law enforcement increased the risk of substance abuse (Exp(B) = 0.357, p = 0.003). Conclusion Family and community dynamics, particularly parental behaviour, peer pressure, and ineffective institutional regulation, are central drivers of youth substance abuse. Strengthening parental involvement, enforcing household rules, and improving law enforcement and community-based interventions are important in reducing the burden of substance use. The study highlights the need for multisectoral action involving families, schools, religious institutions, and law enforcement, while providing evidence to inform prevention strategies and future research on contextual risk pathways. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-1279/v1", "name": "Family and Community Dynamics of Substance Abuse Among Youths in Bushenyi..." } } ] } Home Browse Family and Community Dynamics of Substance Abuse Among Youths in Bushenyi... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Bunu UO, Andrew T, Sunday BY and Isyaku MU. Family and Community Dynamics of Substance Abuse Among Youths in Bushenyi District, Western Uganda [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :1279 ( https://doi.org/10.12688/f1000research.171271.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Family and Community Dynamics of Substance Abuse Among Youths in Bushenyi District, Western Uganda [version 1; peer review: awaiting peer review] Umi Omar Bunu https://orcid.org/0009-0002-0797-7888 1 , Tamale Andrew 1 , Bot Yakubu Sunday https://orcid.org/0000-0001-8140-1276 2 , Mikail Umar Isyaku https://orcid.org/0009-0001-9677-7011 3 Umi Omar Bunu https://orcid.org/0009-0002-0797-7888 1 , Tamale Andrew 1 , Bot Yakubu Sunday https://orcid.org/0000-0001-8140-1276 2 , Mikail Umar Isyaku https://orcid.org/0009-0001-9677-7011 3 PUBLISHED 18 Nov 2025 Author details Author details 1 Department of Public Health, Kampala International University - Western Campus, Bushenyi, Western Region, 71, Ishaka, Uganda 2 Department of Medical Laboratory Science, Kampala International University - Western Campus, Bushenyi, Western Region, 71, Ishaka, Uganda 3 Department of Human Anatomy, Faculty of Biomedical Sciences, Kampala International University, Kampala, Central Region, Uganda Umi Omar Bunu Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Tamale Andrew Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Bot Yakubu Sunday Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Mikail Umar Isyaku Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW This article is included in the Addiction and Related Behaviors gateway. Abstract Background Youth substance abuse is an escalating public health challenge in Uganda, undermining individual well-being, family stability, and community development. Understanding the influence of family and community dynamics is critical for designing effective prevention strategies. Aim This study investigated the relationship between family and community factors and substance abuse among youths in Bushenyi District, Western Uganda. Methods A cross-sectional study design was employed. Structured questionnaires were administered to 381 youths aged 18–30 years, collecting sociodemographic information and data on family and community influences (parental drug use, home rules, peer influence, and law enforcement). Descriptive statistics summarised the data, chi-square tests assessed associations, and logistic regression identified predictors at a 5% significance level. Results Early initiation of drug use was common, particularly in bars and among peer groups. Substance abuse was significantly associated with parental drug use (χ 2 = 102.68, p < 0.001), living arrangements (χ 2 = 21.46, p = 0.001), peer influence (χ 2 = 13.40, p = 0.001), and weak law enforcement (χ 2 = 12.95, p = 0.001). Regression analysis showed that strict home rules were protective (Exp(B) = 0.325, p < 0.001), while weak law enforcement increased the risk of substance abuse (Exp(B) = 0.357, p = 0.003). Conclusion Family and community dynamics, particularly parental behaviour, peer pressure, and ineffective institutional regulation, are central drivers of youth substance abuse. Strengthening parental involvement, enforcing household rules, and improving law enforcement and community-based interventions are important in reducing the burden of substance use. The study highlights the need for multisectoral action involving families, schools, religious institutions, and law enforcement, while providing evidence to inform prevention strategies and future research on contextual risk pathways. READ ALL READ LESS Keywords Keywords: Substance abuse; family dynamics; peer pressure; youth wellbeing and Public health. Corresponding Author(s) Umi Omar Bunu ( [email protected] ) Close Corresponding author: Umi Omar Bunu Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Bunu UO et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Bunu UO, Andrew T, Sunday BY and Isyaku MU. Family and Community Dynamics of Substance Abuse Among Youths in Bushenyi District, Western Uganda [version 1; peer review: awaiting peer review] . F1000Research 2025, 14 :1279 ( https://doi.org/10.12688/f1000research.171271.1 ) First published: 18 Nov 2025, 14 :1279 ( https://doi.org/10.12688/f1000research.171271.1 ) Latest published: 18 Nov 2025, 14 :1279 ( https://doi.org/10.12688/f1000research.171271.1 ) Summary of the key 1. Most youths (41.4%) began drug use between 16–30 years, confirming adolescence and early adulthood as the highest-risk period. 2. Drug use was nearly balanced (51.7% female vs. 48.3% male), reflecting the global trend of increasing female involvement. 3. There was a strong association between parental drug use and youth drug use (χ 2 = 102.68, p < 0.001). Among users, 18.6% reported drug-using fathers and 8.4% reported both parents using drugs, compared to 3.4% who reported maternal use. 4. In contrast, 42.3% of non-users came from drug-free households, underscoring the protective effect of a drug-free family environment. 5. The most protective factor, reducing odds of drug use by 67.5% (Exp(B) = 0.325, p < 0.001). 6. Weak enforcement significantly increased risk (Exp(B) = 0.357, p = 0.003), highlighting the role of structural control. 7. Higher drug use among youths living with friends (82.1%) or alone (64.6%), compared to those living with spouses (43.9%) or family (55.1%) (χ 2 = 21.46, p = 0.001). 8. Nearly all (99.2%) youths whose families raised concerns were confirmed drug users, showing families as effective early warning systems. 9. Significant effect (χ 2 = 13.402, p = 0.000) with 64.6% of influenced youths using drugs, versus 45.7% of those not influenced. 10. Not statistically significant (p = 0.082), suggesting community and peer settings outweigh digital influence in Bushenyi. Introduction Substance abuse remains a pressing global public health challenge, affecting individuals, families, and societies across different cultural and economic settings. According to the World Health Organization ( WHO, 2024 ), the harmful use of substances such as alcohol, cannabis, tobacco, and emerging synthetic drugs contributes to the global burden of disease. Among young people, substance use has been linked to increased risks of mental health disorders, risky sexual behavior, accidents, and long-term socioeconomic vulnerability. The United Nations Office on Drugs and Crime warns that the global increase in youth drug use is compounded by peer influence, weak social structures, and rapid globalization ( UNODC, 2025 ). In Africa, substance abuse is emerging as epidemic that threatens the health and productivity of the continent’s prevalence youthful population. Approximately 60% of Africa’s population is under the age of 25 (Flavio F. Marsiglia et al., 2025 ). This youthful demographic is highly vulnerable to drug and alcohol use, a problem amplified by high unemployment, increasing urbanization, poverty, and shifting cultural norms. Reports indicate that cannabis, alcohol, khat, and prescription drug misuse are the most prevalent substances on the in Africa ( Manariyo & Dusabe, 2025 ). In many African societies, family structures once central in instilling discipline and resilience. This has been challenged by socio-economic hardships affecting their protective role against risky behaviors such as substance abuse ( Donga et al., 2022 ). The situation in East Africa reflects similar dynamics, with the region experiencing increasing trends of alcohol, cannabis, and khat consumption among the youth. Studies from Kenya, Tanzania, Uganda, and Ethiopia have shown that youth substance abuse is strongly associated with peer pressure, weak enforcement of drug laws ( Ebrahim et al., 2024 ). In Uganda’s neighboring countries, khat chewing and alcohol consumption are often normalized in certain cultural settings, reinforcing patterns of early initiation and continued use ( Mbina et al., 2025 ; Ssebunnya et al., 2020 ). The East African Community (EAC) has acknowledged substance abuse as a regional security and health concern, with cross-border trafficking and availability of drugs facilitated by porous borders and expanding trade routes ( Kriegler, 2024 ). Uganda is not exempt from these challenges with the national surveys and research studies reveal a steady rise in substance use, especially among young people aged 15–30 years ( Aber-Odonga et al., 2024 ). Alcohol remains the most commonly abused substance, with Uganda ranked among the highest consumers of alcohol per capita in Africa. Cannabis and locally brewed substances are also widely consumed, while misuse of prescription drugs such as tramadol and codeine is increasing ( UNODC, 2018 ). Factors such as unemployment, poverty, peer influence, and weak family and community monitoring structures drive these patterns. Uganda has established drug control policies and frameworks, including alignment with WHO guidelines and UNODC recommendations ( UNODC, 2025 ; WHO, 2024 ). However, gaps persist in enforcement, rehabilitation infrastructure, and community-based interventions. Bushenyi District in Western Uganda provides a unique case for studying the family and community dynamics of substance abuse. With nearly a quarter of its population composed of youths aged 18–30 years ( Doreen, 2023 ). The district faces growing socio-economic challenges such as high unemployment, urbanization, and cultural shifts. Its location along major highways and trading centers increases exposure to drug trafficking and easy accessibility to alcohol and other substances. Anecdotal evidence and district health reports indicate rising concerns about alcohol and cannabis use among young people, often linked to peer groups, family dynamics, and limited law enforcement ( Kuteesa, 2024 ). Despite these challenges, there is limited empirical research that explores how family structures, community systems, and social environments in Bushenyi interact to shape patterns of youth substance abuse. Addressing this knowledge gap is essential to design evidence-based interventions that reflect both the local context and broader public health priorities. Materials and method Study design This study employed a quantitative research approach with a cross-sectional research design to examine the association between family and community factors (parental drug use, living arrangements, home-based rules, peer group influence, social media, etc.) among youths who engage in substance abuse in Bushenyi District ( Amin, 2005 ). Study area The study was conducted in Bushenyi District, Western Uganda, covering all twelve sub-counties. Bushenyi District was purposively selected due to its large youth population, high unemployment, and location along major highways that increase accessibility to substances through outlets such as bars and trading centers. Study population The study focused on youths aged 18–30 years residing in Bushenyi District, estimated at 52,481 individuals, accounting for 22.9% of the total population ( UBS, 2020 ; NPHC, 2014 ). Inclusion and exclusion criteria The study included youths aged 18–30 years who were permanent residents of Bushenyi District, mentally sound, and willing to provide written informed consent. Individuals were excluded if they were below 18 or above 30 years, did not reside in the district, declined consent, or had any mental impairment that could compromise the reliability of their responses. Sample size determination and sampling technique A total of 381 respondents were selected using Cochran’s formula (1977) for large populations, as shown in Equation (1): n 0 = (z 2 pq) /e 2 (1) where n 0 is the required sample size, z is the standard normal deviate at the desired confidence level, p is the estimated proportion of the target population with the attribute of interest, q = (1 – p), and e is the margin of error. To ensure representativeness, a stratified random sampling technique was first applied, dividing the population into subgroups based on the twelve sub-counties of Bushenyi District. The sample size for each stratum was determined using the proportional allocation method ( Ngunye et al., 2023 ), as indicated in Equation (2): n i = n × P i (2). where n i is the sample size from stratum i, n is the total sample size (381), and P i is the proportion of the population in stratum i. Within each stratum, simple random sampling was then employed to select individual participants, ensuring every eligible youth had an equal chance of being included. For example, in Bumbaire Sub- County, the proportional sample was calculated as: n i = 381 × (3069/52481) ≈ 22. Further stratification by sex was applied, such that males in Bumbaire were allocated as: n male = 22 × ( 6900 / 14700 ) ≈ 10 . This procedure was replicated for all sub-counties to achieve a balanced and representative sample across the district as sumarised in Table 1 . Table 1. Sample distribution per stratum. Sub-county Males Females Sample Bumbaire 10 12 22 Ibaare 9 10 19 Kakanju 10 11 21 Kyabujimbi 24 25 49 Ruhumuro 11 12 23 Kyeizoba 19 21 40 Kyamuhunga 25 26 51 Bitooma 10 11 21 Nyabubare 28 29 57 Central Division 21 21 42 Ishaka division 12 13 25 Nyakabirizi Division 5 6 11 Total 184 197 381 Data collection tools The study utilized semi-structured questionnaire written in English and translated into Runyankole the local language, to ensure participant comprehension. The questionnaire captured participants’ socio-demographic background, types of substances used, frequency and duration of use, sources of substances, and their health and social impacts. The tool was pretested for clarity and reliability following guidelines by Amin (2005) . Data analysis Quantitative data were entered into SPSS version 27 and checked for completeness and accuracy. Descriptive statistics including frequencies, percentages, means, and standard deviations were used to summarized participants’ socio-demographic characteristics and association between family and community factors and substance abuse. Chi-square tests were used to assess associations between categorical variables, and binary logistic regression to identify the association between family and community factors of substance abuse. The results were reported as odds ratios (OR) and 95% confidence intervals (CI). Statistical significance was set at p < 0.05. Ethical considerations This study was conducted in strict adherence to established ethical standards governing research involving human participants. Ethical approval was obtained from the Kampala International University – Western Campus Research Ethics Committee (KIU-2024-509), ensuring that the study complied with institutional guidelines for the protection of participants’ rights, safety, and well-being. In addition, further clearance was secured from the Uganda National Council for Science and Technology (UNCST-HS5415ES) to align the research with national regulatory requirements. All participants were fully informed about the objectives, procedures, potential risks, and benefits of the study before providing written informed consent. In cases where participants were minors, written parental or guardian consent was secured, along with child assent for those old enough to understand the study purpose. Confidentiality of data was maintained throughout the research process, and participants were assured that their involvement was voluntary, with the right to withdraw at any stage without penalty. These measures collectively ensured that the study was ethically sound and respectful of the dignity and autonomy of all participants. Results Prevalence and associated factors responsible for substance abuse The study included 381 participants, and their prevalence and associated factors responsible for substance Abuse are summarized in Table 2 . The mean age of respondents at first drug use was 25.4 years (±3.4), with the majority (41.4%) initiating drug use between 16–30 years, very few reported onsets before 12 years or after 30 years. The gender distribution was relatively balanced, with 51.7% female and 48.3% male participants. In terms of marital status, majority of respondents were either single (42.3%) or married (46.5%), smaller proportions were divorced (7.6%) or widowed (3.7%). The majority of participant were Christians (78.0%), followed by Islam (12.3%), while Hinduism (0.5%) and other affiliations (9.2%) were less common. Educationally, the largest group had attained secondary education (40.4%), followed by post-secondary education (31.0%), primary education (23.1%), and a small proportion had no formal education (5.5%). With respect to employment, most respondents were self-employed (44.4%), while others were employed (28.9%), unemployed (20.7%), or reported other statuses such as students or retirees (6.0%). Regarding residence, 65.1% lived in owned or rented homes, 32.8% stayed with family or friends, while a few lived in dens (1.8%) or rehabilitation centers (0.3%). Table 2. Prevalence and associated factors responsible for substance abuse. Variable Category Percentage (%) Initiation Age 30 0.3% Gender Male 48.3% Female 51.7% Marital Status Single 42.3% Married 46.5% Divorced 7.6% Widowed 3.7% Religion Islam 12.3% Christian 78.0% Hinduism 0.5% Others 9.2% Education Primary 23.1% Secondary 40.4% Post-Secondary 31.0% Others (No formal education) 5.5% Employment Employed 28.9% Unemployed 20.7% Self-Employed 44.4% Others (None, student, retired, etc.) 6.0% Residence Owned/Rented 65.1% Family/Friend 65.1% Rehab 0.3% Dens 1.8% Frequency and types of substance abuse in the study locality 55.4% of the participants reported having used drugs, 44.6% had never engaged in substance use as summarized in Table 3 . Among those who reported use, alcohol was by far the most prevalent substance (89.4%), reflecting both commercially manufactured brands and a variety of traditional brews such as Spirit, Chang’aa, Busaa, Muratina, Wine, Miraj, Kuber, Ice, Akiriga, Bugand, Kombucha, and Waragi. This dominance of alcohol highlights its widespread accessibility, social acceptability, and cultural integration within the study area. Furthermore, several respondents indicated using multiple alcohol-related products, which reveal the diversity and availability of alcohol in the community. Other substances were reported at much lower levels. Cigarettes (9.1%) and marijuana (7.0%) were the next most common, only a small fraction of respondents mentioned using cocaine (1.4%). Table 3. Frequency and types of substance abuse in the study locality. Types of drug abuse Percent (%) Alcohol 89.4 Marijuana 7.0 Cigarettes 9.1 Cocaine 1.4 Total 100.0% Early exposure to substances and drugs by respondents Findings indicate that most respondents were first exposed to substances in social environments, particularly informal and unregulated spaces as summarized in Table 4 . The most frequently reported setting was bars or pubs (45.0%), where substances are openly available and peer gatherings are common. This was followed by friends’ homes (30.3%), reflecting peer-to-peer influence and experimentation in private spaces, and home environments (18.1%), which may indicate exposure through family members or lack of parental monitoring. A smaller proportion of respondents cited exposure in markets (3.8%), schools (1.9%), and even army barracks (0.5%), highlighting that although less common, substance use initiation is not limited to traditional social settings. Majority (81.0%) reported being with friends indicating the role of peer groups in initiating and normalizing substance use behaviors. Siblings (11.4%) and parents (4.7%) were also mentioned, suggesting that family contexts may, in some cases, facilitate early exposure. A smaller proportion of respondents reported being alone (1.9%), or accompanied by bar attendants (0.5%) and boyfriends (0.5%), which points to additional pathways of influence outside the immediate peer or family context. Table 4. Early exposure to substances and drugs by respondents. Percentage (%) Location Home 18.1 Bar/Pub 45.0 Friend’s Home 30.3 Market 3.79 School 1.9 Army Barracks 0.5 Companion Friends 81.5 Parents 4.7 Siblings 11.4 Bar Attendant 0.5 Self 1.9 Association between drug usage and parental drug use The analysis reveals a strong association between parental drug use and youth drug involvement. Among respondents whose fathers used drugs, 18.6% reported drug use compared to only 2.9% who did not. Similarly, where both parents used drugs, 8.4% of respondents reported drug use, against 1.7% non-users, suggesting intergenerational modeling of behavior. Maternal drug use also showed an effect, though smaller (3.4% users vs. 0.6% non-users). In contrast, the largest protective group came from drug-free households: 42.3% of non-users compared to 24.7% of users reported that neither parent used drugs. This underscores the importance of parental abstinence in reducing youth vulnerability. A negligible proportion (0.3%) reported drug use when other relatives, but not parents, were involved. The relationship between youth substance abuse and parental drug use is presented in Table 5 . The analysis indicates a statistically significant association between respondents’ drug use and parental drug use (χ 2 = 102.68, df = 4, p = 0.000, p < 0.05). Table 5. Association between drug usage and parental drug use. Parental drug use Drug usage: No (%) Drug usage: Yes (%) Mother 0.6% 3.4% Father 2.9% 18.6% Both 1.7% 8.4% None of them 42.3% 24.7% Relative 0.0% 0.3% Association between drug usage and living arrangement Results indicate higher substance abuse among youths living alone or with friends compared to those residing with family or spouses, suggesting that household supervision and structure may serve as protective factors. The results presented in Table 6 show statistically significant association between drug usage and the respondent’s living arrangement ( χ 2 = 21.46, df = 3, p = 0.001, p < 0.05). Individuals living alone or with friends showed higher rates of drug usage compared to those living with spouses or family. Table 6. Association between drug usage and living arrangement. Living arrangement Drug usage: No Drug usage: Yes Alone 35.4 64.6 Spouse 56.1 43.9 Family (Parents, siblings, children) 44.9 55.1 Friend(s) 17.9 82.1 Association between drug usage and selected contributing factors The analysis revealed that peer influence was strongly associated with drug use summarized in Table 7 . Respondents who identified peer influence as a contributing factor were significantly more likely to report drug use compared to those who did not (χ 2 = 13.402, df = 1, p = 0.000). Specifically, among the 212 respondents who cited peer influence, 137 (64.6%) reported drug use, compared to only 74 (45.7%) among the 162 who did not cite peer influence. This indicates that peers play a substantial role in encouraging initiation and continuation of drug use among youths. Similarly, weak laws were significantly associated with drug use (χ 2 = 12.945, df = 1, p = 0.000). Among the 86 respondents who perceived weak laws as a contributing factor, 34 (39.5%) reported drug use, compared with 177 (61.5%) among the 288 who did not view weak laws as a factor. This finding suggests that inadequate enforcement and lenient penalties for drug-related offenses increase the likelihood of youth engaging in substance use, as they perceive minimal legal consequences. In contrast, social media influence did not show a statistically significant association with drug use (χ 2 = 2.960, df = 1, p = 0.085, p > 0.05). While 32 out of 68 respondents (47.1%) who cited social media as a contributing factor reported drug use, this proportion was not substantially different from the 179 out of 306 (58.5%) who did not. This suggests that, although social media may expose youths to drug-related content, its influence in this setting is less pronounced compared to direct peer and community-level influences. Table 7. Association between drug usage and selected contributing factors. Contributing factor Category Drug usage: No Drug usage: Yes Total χ 2 (df ) p-value Peer Influence Not a reason (0) 88 74 162 13.402 (1) 0.000 A reason (1) 75 137 212 Social Media Not a reason (0) 127 179 306 2.960 (1) 0.085 A reason (1) 36 32 68 Weak Laws Not a reason (0) 111 177 288 12.945 (1) 0.000 A reason (1) 52 34 86 Drug usage and family complaints The analysis examined the relationship between drug use and family complaints, focusing on concerns expressed by parents, siblings, or spouses. Out of the 252 valid respondents, 202 (80.2%) reported drug use, 50 (19.8%) reported no drug use. Family concern was strongly associated with drug involvement with among respondents whose families had raised complaints. 129 of 130 (99.2%) admitted to drug use, compared to 73 of 122 (59.8%) among those without complaints. The chi-square test confirmed this association (value of 61.413 with a p-value of 0.000) as statistically significant (χ 2 = 61.413, df = 1, p = 0.000), demonstrating that family complaints are a reliable indicator of youth substance involvement. These findings suggest that families not only recognize drug-related behaviors but may also serve as an important early warning system for identifying substance abuse presented in Table 8 . Table 8. Drug usage and family complaints. Family members complained about drug involvement Drug use: No Drug use: Yes No 98% 36.1% Yes 2.0% 63.9% Multivariate analyses of drug usage among youths in Bushenyi District The logistic regression model examined psychosocial and environmental predictors of drug use among youths in Bushenyi District as presented in Table 9 . The analysis revealed that household rules on drug use were a strong and statistically significant protective factor. Youths from households with clear anti-drug rules were substantially less likely to engage in substance use (B = -1.125, p = 0.000, Exp(B) = 0.325, 95% CI: 0.230–0.458). Similarly, weak law enforcement emerged as a significant risk factor. Respondents perceiving drug laws as weak had increased odds of drug involvement (B = -1.030, p = 0.003, Exp(B) = 0.357, 95% CI: 0.183–0.698). Other variables approached, but did not reach, statistical significance. Parental drug use was borderline (B = -0.441, p = 0.063, Exp(B) = 0.643), suggesting a potential intergenerational effect worth further exploration. Social media influence also approached significance (B = -0.627, p = 0.082, Exp(B) = 0.534), indicating complex indirect effects that may moderate or buffer risk. In contrast, peer influence was not statistically significant (p = 0.280), possibly due to shared variance with stronger predictors such as household and legal factors. Living arrangements also showed no significant impact (p = 0.495). Table 9. Multivariate analyses of drug usage among youths in Bushenyi District. Variable B S.E. Wald df Sig. Exp(B) 95% CI lower 95% CI upper Who do you live with 0.115 0.169 0.465 1 .495 1.122 0.806 1.562 Who among your parents uses drugs -0.441 0.238 3.448 1 .063 0.643 0.404 1.025 Home rules on drug abuse -1.125 0.176 40.971 1 .000 0.325 0.230 0.458 social media -0.627 0.361 3.016 1 .082 0.534 0.263 1.084 Weak Laws -1.030 0.342 9.072 1 .003 0.357 0.183 0.698 Peer Influence 0.356 0.330 1.167 1 .280 1.428 0.748 2.723 Constant 5.450 0.947 33.135 1 .000 232.644 Discussion This study examined the role of family and community dynamics shaping substance abuse among youths in Bushenyi District, Western Uganda. The findings highlight the interplay of socio-demographic characteristics, early social exposure, family influences, and structural factors such as law enforcement in driving youth drug use. The socio-demographic profile revealed that majority of respondents initiated drug use between 16–30 years. This is consistent with global evidence that adolescence and early adulthood are the windows of vulnerability to substance use due to peer pressure, experimentation, and increasing independence ( UNODC, 2023 ). The balanced gender distribution further reflects changing social norms where substance use is no longer prevalence in male ( Cosma et al., 2022 ). These findings align with international trends that show an increasing involvement of females in substance use. Social environments emerged as the prevalent sites for early exposure, particularly bars and friends’ homes, indicating the role of informal and unregulated spaces in initiating drug behavior. This aligned with another study conducted in Mbala District Uganda ( Aber-Odonga et al., 2024 ) and another in Ghana ( Appati et al., 2025 ) respondents were reported to have initiated substance abuse with friends or peer groups. It has also been documented in global literature, where peer groups are recognized as primary vectors of initiation ( Laursen & Veenstra, 2021 ). However, multivariate analysis showed that peer influence reduced when family and structural predictors were included, suggesting that peers operate within broader family and community frameworks. This is also consistent with another systematic review which indicated that peers catalyze initiation of substance abuse, sustained risk is more strongly governed by household and policy structures ( Nawi et al., 2021 ). Furthermore, Family dynamics were central in shaping drug use with significant association between parental drug use and youth drug involvement (χ 2 = 102.68, p < 0.001). These finding support the theory of intergenerational transmission of behavior ( Nawi et al., 2021 ). Fathers appeared to exert stronger modeling influence, although maternal and dual-parental use also mattered. In contrast, drug-free households provided protection. These findings align with systematic reviews, such as those endorsed by the U.S. Community Preventive Services Task Force, which identify family-based prevention through rule-setting, communication, and monitoring as one of the most effective approaches to reduce youth substance use ( Jacob et al., 2025 ). Similarly, household rules in this study emerged as the strongest protective factor (Exp(B) = 0.325, p < 0.001), reinforcing global evidence that structured family environments are important in controlling drug use ( UNODC, 2018 ). At the community level, weak enforcement of drug laws significantly increased risk (Exp(B) = 0.357, p = 0.003). This finding resonates with WHO’s recommended “best buys” for alcohol and substance control, which emphasize restrictions on availability, outlet density, and marketing, supported by robust enforcement ( El Zibaoui et al., 2025 ). It also consistent with another systematic review and meta-analysis conducted in west Africa where limited enforcement capacity contributes to higher local availability of substances and increased vulnerability among youths ( Emmanuel et al., 2024 ). Another important finding was the associated between family complaints and drug use. Approximately 99% of youths whose families raised concerns being confirmed users, families appear to serve as reliable early warning systems. This suggest the need for prevention programs that empower families to recognize, respond to, and support at-risk youths, consistent with WHO’s emphasis on strengthening community and family engagement in public health responses ( UNODC, 2018 ). Social media influence was not statistically significant (p = 0.082), in contrast to global evidence that increasingly identifies digital platforms as important drivers of youth substance use through marketing and peer influence. In the Bushenyi context, however, direct peer interactions and physical environments such as bars may overshadow online influences. Nevertheless, this presents an opportunity that while social media may not currently drive substance abuse. It could be repurposed as a scalable tool for prevention messaging, aligning with WHO and UNODC recommendations for community- and school-based awareness campaigns ( UNODC, 2018 ; WHO, 2018 ). Thus, the evidence suggests that reducing youth substance abuse in Uganda requires a multi-level approach with scaling family-based interventions, ensuring community-level enforcement of existing laws, and integrating peer-focused prevention programs. The alignment of these results with WHO “best buys,” UNODC regional analyses, and FDA enforcement logic indicate both the universality of these dynamics and the urgent need to adapt them to Uganda and beyond. Conclusion This study demonstrates that substance abuse among youths in Bushenyi District, Western Uganda, is shaped by a complex interplay of family, peer, and community-level factors. Early initiation typically occurs in informal and unregulated settings such as bars and friends’ homes, with peer networks playing a significant role in exposure and normalization. However, parental modeling, household rules, and family complaints emerged as the most decisive influences, highlighting both the risks of intergenerational transmission and the protective value of structured family environments. At the structural level, weak enforcement of drug laws significantly increased the likelihood of drug use, underscoring the gap between legal frameworks and practical implementation. While social media was not a major driver in this setting, it remains a potential avenue for delivering targeted prevention interventions. Collectively, these findings align with international trends and global policy frameworks, including WHO “best buys” for alcohol and substance control, UNODC regional analyses, and FDA enforcement strategies, emphasizing the need for integrated, multi-level interventions. Strengthening family-based prevention, improving law enforcement, and developing community-driven and peer-focused interventions represent critical steps toward reducing substance use among Ugandan youth. Policymakers, health practitioners, and community leaders must therefore collaborate to build resilient systems that protect young people, while also adapting international best practices to the unique socio-cultural realities of Uganda. Consent for publication Not applicable. Data availability The datasets generated and analyzed during this study are not publicly available due to ethical restrictions related to the confidentiality of participants’ personal health information. According to the approval conditions set by the Kampala International University – Western Campus Research Ethics Committee (KIU-2024-509) and the Uganda National Council for Science and Technology (UNCST-HS5415ES), public sharing of identifiable or potentially identifiable data from human participants is not permitted in order to protect participant privacy. However, de-identified data supporting the findings of this study can be made available upon reasonable request to qualified researchers. Access will be granted only after review and approval by the KIU-WC Research Ethics Committee, and in compliance with the Uganda National Research Ethics Guidelines. 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Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 18 Nov 2025 ADD YOUR COMMENT Comment Author details Author details 1 Department of Public Health, Kampala International University - Western Campus, Bushenyi, Western Region, 71, Ishaka, Uganda 2 Department of Medical Laboratory Science, Kampala International University - Western Campus, Bushenyi, Western Region, 71, Ishaka, Uganda 3 Department of Human Anatomy, Faculty of Biomedical Sciences, Kampala International University, Kampala, Central Region, Uganda Umi Omar Bunu Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Tamale Andrew Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Bot Yakubu Sunday Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Mikail Umar Isyaku Roles: Conceptualization, Data Curation, Funding Acquisition, Methodology, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 18 Nov 2025, 14:1279 https://doi.org/10.12688/f1000research.171271.1 Copyright © 2025 Bunu UO et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Bunu UO, Andrew T, Sunday BY and Isyaku MU. Family and Community Dynamics of Substance Abuse Among Youths in Bushenyi District, Western Uganda [version 1; peer review: awaiting peer review] . 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